July 24, 2012 -- This month the global news media ran short reports about a new study from University College Dublin (Ireland) that found that the most popular nurse-related YouTube videos stereotype nurses as stupid sex objects. On July 16, an Agence France-Press item posted on The Telegraph (Australia) and other news sites described basic aspects of the study and included several quotes from the lead author, nursing professor Gerard Fealy. The study found that, of the 10 most popular nurse-related YouTube videos, four portrayed nurses as sex objects, two showed nurses as stupid or incompetent, and only four--all posted by nurses themselves--showed nursing as a skilled and caring profession. All six of the stereotypical depictions were from television products or ads. Today, The Irish Times ran a good longer report by Ronan McGreevy that included more details about the study and the videos, as well as more quotes from Professor Fealy and Geraldine Talty of the Irish Nurses and Midwives Organisation. Among the new details were that the most popular YouTube video was a naughty nurse depiction from the 1990s U.S. sitcom Frasier. Another popular video showed a nurse responding to a question about whether she could do anything without a physician's permission by declaring that she could "wipe dirty ass and change diapers." Although it might have been helpful to hear more about the four videos that did not stereotype the nurses as sex objects or idiots, these press reports are generally good. We thank those responsible, as well as the nursing scholars who conducted the study. And we look forward to the day when popular media creators realize that nurses are college-educated, life-saving science professionals of both genders. Nurses can help bring that day closer by heeding YouTube's advice to "broadcast yourself."

The Agence-France Press (AFP) item was headlined "YouTube videos 'show nurses as stupid sex objects,'" although the piece does not make clear where that quote is from. The report does explain that researchers led by Fealy, "a professor of nursing and midwifery at University College Dublin," analyzed "the 10 most-viewed clips on the popular video-sharing site in response to the keywords 'nurses' and 'nursing.'" Four of the videos, all posted by nurses, "showed the job of caregiver as skilled, professional and rewarding." But two clips, from a cartoon and an unnamed U.S. sitcom, "showed nurses as stupid or incompetent." And the other four, from Frasier, a Virgin Mobile ad, "a Belgian lingerie commercial and an item from an Internet TV news show," showed nurses as "scantily dressed or willing participants in male sexual fantasies." The item also includes several quotes from Professor Fealy, who observes that YouTube, "despite being hailed as a medium of the people . . . is no different to other mass media in the way that it propagates gender-bound, negative and demeaning nursing stereotypes." Fealy stresses that "such stereotypes can influence how people see nurses and behave towards them." And he urges "the professional bodies that regulate and represent nurses . . . to lobby legislators to protect the profession from undue negative stereotyping and support nurses who are keen to use YouTube to promote their profession in a positive light."

This piece does a good job of explaining the basic import of the study in a short space. And it commendably tells readers that nurses can be university professors who conduct scholarly research, which--given the findings of the study itself--is obviously not a message that is universally understood. The piece might have also let readers know that Dr. Fealy (right) has a PhD in nursing.

But including several quotes from Fealy does show that nurses can provide expert input. And he makes an excellent point about YouTube as the "medium of the people." The fault for poor understanding lies not just in elite media creators in world capitals and Hollywood, but in all of us who do not look closely enough at what nurses really do and who accept the easy stereotypes that have plagued the profession for decades. That is, the fault is not just in our stars, but in ourselves; the media both reflects and reinforces poor understanding of nursing.

Fealy's comment about the real effects these videos have on people is also very helpful. That is another point that you might think would be obvious, but which nurses must constantly make and defend. Media creators and their allies often claim that the media has no effect on the real world (unless the media is receiving praise). Television, of course, is a special problem, as the results of this study show. We suspect a comparable survey focusing only on that still-dominant medium would produce even more troubling results; 40% of the most popular items would not have been posted by nurses themselves.

Finally, we appreciate Professor Fealy's call for legislators to help. Governments should include projects to improve understanding of nursing in their public health efforts. But we would not advocate that governments act against "undue negative stereotyping" if that meant censoring media creators. We don't think the government should ban speech that harms nursing, which would be counterproductive on the whole, but rather that everyone should advocate until media creators learn enough to reconsider what they are doing.

"We really haven't spoken out in big numbers against it"

Ronan McGreevy's piece in today's Irish Times "Nurse stereotypes as sex objects persist on internet, study finds," has more detail about the study. The report starts with the bottom line, which is that the study found that stereotypes of nurses as "sexual playthings" or "witless incompetents" "persist in social media." But then the news article gives the paper's title ("The Image of You: Constructing Nursing Identities in YouTube") and publication (The Journal of Advanced Nursing), and it also notes that co-author Fealy is at the UCD School of Nursing, Midwifery and Health Systems.

The piece includes significant comment from Dr. Fealy, and it consistently refers to him as "Prof Fealy," which underlines his status as a university scholar, though again, it would have been nice to hear that he has a doctorate. Fealy says that nursing stereotypes have been around a long time, and that they include "the 'battle-axe' type matron figures found in Carry On Matron (right) and One Flew Over the Cuckoo's Nest." The piece notes that "the first perception in social media he found was that all nurses were female"--neatly making the point, just by the fact that Fealy is male, that that perception is wrong. Fealy also conveys balance when he admits that many of the media portrayals have comic value and even that some may find his study to be the result of "a bit too much introspection." But "we argue that these sorts of images and identities convey a distorted image to the public." Providing further balance, Fealy stresses that there are positive media portrayals, "most notably the US television series Nurse Jackie. Despite this character being a flawed individual who has a prescription medicine addiction, he maintained she was 'intelligent, savvy and highly competent.'"

The report also includes comment from Geraldine Talty (right), who is "a member of the Irish Nurses and Midwives Organisation (INMO) executive council." Talty correctly notes that the stereotyping in traditional media now appears in social media and that the public does not understand how complex nursing is today. She also argues that (in the piece's words) "other professions would not take well to being portrayed as 'scantily clad and easily had.'" And she makes a crucial point: "I believe that is continuing over the years because we really haven't spoken out in big numbers against it." Right. That is what must change.

The piece also includes helpful additional detail about the videos themselves. It notes that the Frasier clip, in which the character Daphne "dresses up as a sexy nurse," was the most popular, with more than a million hits. One of the other naughty nurse images was a "news report about nurses in the Netherlands complaining of sexual harassment by patients in which the presenter remarks: 'What are the nurses doing in Holland? I've got to get myself a nurse in Holland.'" Nice job, news media! And of the videos portraying nurses as "stupid," one shows a nurse "being asked whether she can do anything without the doctor's permission, to which she replies: 'I can wipe dirty ass and change diapers.'"

Both the AFP item and the Irish Times report convey the essence of the YouTube study with key details that help readers understand the problems in the nursing image and offer at least a glimpse of what might be done to improve it. It might have been good to hear a little about the four videos that the study found presented nurses as caring professionals, which would (hopefully) at least give readers some sense of what nursing is really like. And the articles give readers information about the nursing scholar who led the study that should itself counter the stereotypes, at least in a small way. We thank all those responsible for these reports.